Pandemic 1918

by Catharine Arnold

  From then on I went to work with him. We had to shut down the whole second floor of the store – ladies ready-to-wear and our big millinery department – which was a momentous decision. Business was very, very sparse.

  Then my father told me already three of his eight employees had died. He told me, ‘Miss Leah will not be coming back.’ I said, ‘Why not?’ He said, ‘Because Leah died.’ Miss Leah was the first of his employees to die.

  I was old enough to understand what death was. I suddenly realized what was happening, that many of our good friends and people who loved us were going to die.18

  The experience left Dan with little faith in the medical profession. It seemed that there was nothing doctors could do to help, or to prevent the relentless progress of the Spanish Lady with her trail of death. ‘The medical world did not know how to handle the disease. Doctors didn’t have any medicines or vaccines. And since doctors didn’t have the cure-all in their little black satchel, there was very little they could do.’19

  But the doctors did try. Civilian practitioners, mostly old or dragged out of retirement, struggled valiantly to save the lives of their patients. Over in Ashville, North Carolina, future novelist Thomas Wolfe witnessed the local doctor’s attempts to save his brother’s life as the community gathered round to try to save their son.

  Thomas Wolfe’s Look Homeward, Angel contains one of the most explicit descriptions of Spanish flu in modern literature, based on the experiences of Wolfe’s brother, Benjamin Harrison Wolfe, who was just twenty-five. While Wolfe’s language may strike the reader as a slice of Southern Gothic, overblown and grotesque, then so was Spanish flu.

  Wolfe’s protagonist, Eugene Gant, a thinly veiled version of the author himself, had escaped his stifling small-town life in North Carolina when a letter arrived from his mother telling him that Spanish flu had made inroads in his home town: ‘Everyone has had it, and you never know who’s going to be next,’ she wrote. ‘It seems to get the big strong ones first. Mr. Hanby, the Methodist minister, died last week. Pneumonia set in. He was a fine healthy man in the prime of life.’20

  Eugene heard nothing more for several weeks but then, one rainy evening, he was summoned home with the news that his brother, Ben, was desperately ill with pneumonia of both lungs. Returning to the family home, a grim small-town lodging house, Eugene witnessed a horrific vision of Ben gasping for breath like an enormous insect on a naturalist’s table, ‘fighting, while they looked at him, to save with his poor wasted body the life that no one could save for him. It was monstrous, brutal.’21

  After the family had spent the night on tenterhooks, nervously tiptoeing outside the sickroom door, Ben’s condition seemed to improve. But he went downhill again in the afternoon, and attempts to administer oxygen were unsuccessful. When the nurse tried to place the cone over Ben’s face, he ‘fought it away tigerishly’.22

  The Gant family prepared themselves for the end, all hoping that Ben would pass peacefully. But at the last moment Ben rallied, and in one final surge of life there was a glimpse of the old Ben, the character, the town rebel. ‘Ben drew upon the air in a long and powerful respiration; his gray eyes opened, and … he passed instantly, scornful and unafraid, as he had lived, into the shades of death.’23

  CHAPTER TWELVE

  ‘YOU CAN’T DO ANYTHING FOR FLU’

  AS THE SPANISH Lady continued her campaign of global terror, food and pharmaceutical manufacturers seized on the commercial potential of the epidemic. Respectable proprietary brands such as Oxo and Milton, Jeyes’ Fluid and Black & White Whisky, bought advertising space alongside quacks and snake oil salesmen, all keen to persuade a desperate public to purchase their wares. Alongside over-the-counter products, frightened families also turned to folk remedies, traditional and reassuring cures familiar to their heritage, whether this be onions, asafoetida (a foetid-smelling herb historically used for chest complaints) or opium. As the mortality rates soared, so too did the willingness to try something, anything, to save themselves and their loved ones from a horrible death. And while attempts to develop a vaccine against Spanish flu floundered, doctors pioneered other methods to care for its victims, from the ‘rooftop cure’ where patients were exposed to the elements, to an experiment with potassium permanganate on British public schoolboys.

  From the apparently innocuous first wave during the early spring of 1918, to the escalating second wave of Spanish flu that gripped the world in the later months of the year, daily newspapers carried an increasing number of advertisements for influenza-related remedies as drug companies played on the anxieties of readers and reaped the benefits. From The Times of London to the Washington Post, page after page was filled with dozens of advertisements for preventive measures and over-the-counter remedies. ‘Influenza!’ proclaimed an advert extolling the virtues of Formamint lozenges. ‘Suck a tablet whenever you enter a crowded germ-laden place.’

  Another advertisement announced that ‘as Spanish Influenza is an exaggerated form of Grip’, readers should take Laxative Bromo Quinine in larger doses than usual, as a preventive measure. For those who had already succumbed, Hill’s Cascara Quinine Bromide promised relief, as did Dr Jones’s Liniment, previously and mysteriously known as ‘Beaver Oil’ and intended to provide relief from coughing and catarrh. Demand for Vick’s VapoRub, still popular today, was drummed up by press adverts warning of imminent shortages:

  DRUGGISTS!! PLEASE NOTE VICK’S VAPORUB OVERSOLD DUE TO PRESENT EPIDEMIC.

  Ely’s Crème Balm, which ‘may prevent Spanish influenza when applied in the nostrils’, appears to have been a copycat product, while more traditional remedies were available in the form of Lydia E. Pinkham’s famous Herb Medicine and Hale’s Honey of Horehound and Tar.

  With the threat of the Spanish Lady looming large, familiar household products became suddenly endowed with magical powers. While readers of the Nottingham Journal were wisely informed that ‘OXO appreciably compensates for the shortage of meat’,1 another, more elaborate advert declared that Oxo ‘fortifies the System against Influenza Infection’. According to a testimonial obtained ‘from a Doctor’,

  A cupful of OXO two or three times a day will prove an immense service as a protective measure. Its invigorating and nourishing properties are most rapidly absorbed into the blood, and thus the system is reinforced to resist the attacks of the malady. It will be apparent that a strong healthy person will escape contagion when the ill-nourished one will fall a victim, consequently, one’s aim must be the maintenance of strength.

  The benefit to the community of a concentrated Fluid Beef like OXO is greater than ever in the present day; it increases nutrition and maintains vitality in the system, and thus an effective resistance is established against the attacks of the influenza organism.2

  If Oxo did not appeal, Horlick’s Malted Milk was recommended as THE diet ‘During and After Influenza’.3

  Americans were informed that it was their patriotic duty to ‘Eat More Onions!’ as part of a ‘Patriotic Drive Against the “Flu.”’ One placard proclaimed:

  An onion car arrived today

  Labelled red, white and blue

  Eat onions, plenty, every day

  And keep away the ‘Flu.’4

  An American mother took this suggestion to extremes, and fed her sick daughter syrup made from onions before wrapping her in onions from head to toe. Fortunately, the outcome was successful and the child survived.5

  While the actual nature of the Spanish flu organism still awaited discovery, doctors and laymen alike knew that treatment should focus on the avoidance of germs and microbes. As a result, contemporary newspaper adverts revealed a compulsive obsession with personal and domestic hygiene. As Spanish flu made inroads into the British midlands, the Nottingham Journal carried an advertisement for Gossages’ Purified Carbolic Soap, 9d per pound, recommended on ‘Doctors’ Orders’ to clean floors, wash-tub, bath and toilet. ‘It disinfects as it cleanses. Use it for all purposes.’ Readers were also reminded that
‘no house is safe without Milton’ (the sterilizing solution).6 At Repton, a boys’ boarding school in Derbyshire, the school doctor experimented by administering tobacco snuff to the boys and spraying their throats with a solution of potassium permanganate, an inorganic chemical compound used as an antiseptic, with apparently successful results: the rate of infection was low.7

  Conventional medical advice for the treatment of influenza included morphine, atropine, aspirin, strychnine, belladonna, chloroform, quinine and, disturbingly, kerosene, which was administered on a sugar lump. Alongside these, folk remedies thrived. If a product from the drugstore failed to alleviate the symptoms, many patients and their families turned to more traditional methods. One popular remedy in South Africa was to place a block of camphor in a bag and tie it around the patient’s neck. One eight-year-old girl, who was taking no chances, announced that she was wearing a camphor bag around her neck ‘to keep off the Germans’.8 The practice was so widespread that, over half a century later, an elderly South African lady in a nursing home, who had survived the 1918 outbreak, refused inoculation against the 1969 epidemic of Hong Kong flu. ‘Not for me,’ she maintained. ‘I still have my camphor bag.’9

  In North Carolina, young Dan Tonkel had taken to wearing a bag of asafoetida around his neck, in the belief that the stinking extract would protect him. ‘It smelled to high heaven,’ he recalled.10 ‘People thought the smell would kill germs. So we all wore a bag of asafetida and smelled like rotten flesh.’11 In Philadelphia, Harriet Ferrel was rubbed with tree bark and sulphur, and forced to drink herbal teas and take drops of turpentine and kerosene on a lump of sugar. Harriet was also subjected to the asafoetida treatment but was philosophical: ‘We smelled awful, but it was okay, because everyone smelled bad.’12 Robert Grave’s ‘Welsh gypsy’ housemaid had an even more unusual form of protection, consisting of ‘the leg of a lizard tied in a bag around her neck’.13 It was clearly successful as she was the only person in the Graves household who did not develop Spanish flu. In South Africa, a traditional cure for the ‘longpest’ consisted of placing a recently killed animal on the patient’s chest.14

  The success of traditional remedies owed much to the placebo effect, although it was not always possible to follow up the results. In Meadow, Utah, William Reay was appointed Health Officer and spent his time riding from house to house and farm to farm checking up on families to see who was sick and needed help. One morning, accompanied by the city Marshal, George Bushnell, Reay rode out to check up on a group of Pahvant Indians, members of the Ute tribe, camped six miles out of town at the edge of a canyon.15 Influenza had hit the camp and Reay and Bushnell were horrified to discover that the Indians were observing their traditional custom of sitting around the dead bodies and singing them to the Happy Hunting Grounds.16 Reay and Bushnell moved the bodies to separate tents, which they sewed up until the bodies could be buried. Then they turned their attention to the living.

  ‘The Indians were moaning, “Medicine, medicine, medicine.” The Medicine Man was sick. Reay and Bushnell asked the Chief (who was so sick he could hardly talk) if they could bring up some medicine from Meadow.’17

  Meadow’s only doctor was also sick with influenza, so Reay went to visit the local ‘wise woman’, Aunt Martha Adams, who gave him some herbs, including horehound, a herb used to create expectorant and a traditional remedy for fever. Reay took these home and stewed them up in the five-gallon wash boiler, adding other items, including bacon – as it was believed that wrapping a rasher of bacon around the neck would cure a sore throat – and anything else he thought might help. ‘And we cooked it up and it smelled like medicine and it tasted like medicine and put in a lot of honey so it would taste good,’ remembered Reay’s son, Lee. ‘Then we bottled it and put a label on it, “The Influenza Medicine.” It wasn’t real medicine, of course, but it made people feel better, because they thought it was medicine.’18

  The medicine was taken up to the camp, and young Lee watched from a safe distance as the Indians drank it and the men dug graves. Lee and his father never knew whether or not the medicine had made a difference. As soon as they were well enough to travel, the Pahvant Indians took down their tents and went away. ‘They were afraid, and they just left,’ said Lee. ‘I don’t know where they went.’19

  In the Deep South, other traditional remedies were popular. In Louisiana, the superintendent of a Methodist hospital recommended a quilt made of wormwood, sandwiched between layers of flannel and dipped in hot vinegar and placed on the patient’s chest,20 while some residents of New Orleans turned to voodoo and bought charms against Spanish flu. These consisted of ‘anything from a white chicken’s feather to an ace of diamonds for the left shoe’.21 Other voodoo remedies included performing a spell three times a day while rubbing vinegar over the face and palms: ‘Sour, sour, vinegar – Keep the sickness off’n me.’22

  Whiskey had always been a traditional remedy for colds and influenza, and whiskey prices soared in the United States during the epidemic. In Denmark and Canada, alcohol was only available by prescription, while in Poland brandy was regarded as highly medicinal. One brave soul in Nova Scotia recommended fourteen straight gins in quick succession as a cure for Spanish flu.23 The result of this experiment was unknown; if the patient had survived he had doubtless forgotten the proceedings entirely.

  In Britain, the Royal College of Physicians stated that ‘Alcohol Invites Disaster’, a conclusion which was ignored by many.24 The barman at London’s Savoy Hotel created a new cocktail, based on whisky and rum, and christened it ‘the Corpse Reviver!’25 while John Frewer, a soldier from Wisbech, Cambridgeshire, credited his recovery to whiskey:

  As a last resource [the doctor] asked my mother whether I drank whisky as, if I was not accustomed to it, it might have a shock effect on my body and cause the turning point. That night I had a half tumbler of whisky and in a very few minutes was bleeding black blood from my mouth and nostrils. From that time I made slow but steady progress.26

  In the universal panic of the Spanish flu epidemic, many believed that the air itself was poisonous. One woman in Citerno, Italy, sealed up her house so effectively that she died of suffocation.27 Lee Reay of Meadow, Utah, recalled one family who sealed their house up. They plugged keyholes, sealed the windows and even closed the dapper on the stove.28

  Roy Brinkley’s father, a sharecropper in Max Meadows, Virginia, decided that fresh air could be fatal during the epidemic and sealed up his wife and four children in one room. The family spent seven days sitting around the wood-burning stove until it caught fire. As his family fled the house and took refuge in the vegetable patch, Brinkley was convinced that the fresh air would kill them. For the rest of his life, Roy remembered a sudden rush of fresh air and the sight of cabbages, as big as wash tubs. But, once outside, the entire family soon recovered.29

  Many doctors believed that far from being deadly, fresh air was vital to a patient’s recovery, blowing away the foetid contagion of the sick room. When a doctor in Halifax, Yorkshire, smashed a window with a rolling pin, he reported that his gasping patients immediately began to recover. In Alberta, Canada, one doctor treated his patients in tents and they all recovered. At the Ospedale Maggiore in Milan, patients treated in the courtyard for lack of space recovered more quickly than their peers.30 In London, Dr Leonard Hill of the London Hospital recommended that everyone should sleep in the open air, convinced that cool air increased circulation and helped rid the body of toxins.31

  A controversial approach at the Roosevelt Hospital in New York saw children placed on the roof to get the benefit of fresh air. Protected from the wind by screens, they were put to bed with hot water bottles.32 While the general public regarded this treatment as outrageous, six hospitals in Massachusetts followed the Roosevelt’s example. At the beginning of October 1918, Dr Louis Croke of Boston set up a therapeutic community on Corey Hill. The patients were nursed in tents, warmed with hot bricks wrapped in newspaper, and the nursing staff improvised masks by stuffin
g sieves with newspaper. The results appeared to be successful: only 35 patients out of 351 died, compared with the hospitals in Boston, where half the influenza patients perished.33

  In London, Dr William Byam, who had been researching trench fever, was called back to England to treat influenza patients at a hospital in Hampstead. The wards were filling up with patients, while the mortuary was stacked to the ceiling with bodies, as there was no wood available to make coffins. Many victims had died of pneumonia, exhibiting the characteristic blue-purple colour of cyanosis. When yet another patient arrived and developed ‘the dreaded form of pneumonia’ and cyanosis he too was not expected to live. According to Byam, the staff had ‘not seen a case of “blue” pneumonia recover.’34 In addition, the patient was a heavy drinker. Byam persuaded the man’s estranged wife to visit, although she did so reluctantly, having avoided him for twenty years and having no intention of ‘letting him get hold of her again’.35 Byam had to convince the patient’s wife that her husband was as good as dead before she would condescend to visit the hospital.

  When the patient’s wife arrived, she found her estranged husband had turned a deep purple and had breathing difficulties and a weak pulse. In order to supply the patient with oxygen, Byam inserted two hollow needles into the skin of his chest and connected them to a large oxygen cylinder. That night, the nurse on duty fell asleep, probably exhausted by the demands of her patients, while the lingering effects of dental anaesthetic may also have been to blame. Whatever the cause, the nurse must have slumped forward onto the valve regulating oxygen flow, because when she came to, the oxygen cylinder was completely empty. As for the patient, he

  Closely resembled a fully-inflated balloon. His skin was tensely distended with oxygen; even his eyelids were inflated and so swollen that it was impossible to open them even with the finger. Pressure applied to any portion of the body produced a sensation of crackling such as might have been felt had the finger been pressing on a lemon sponge pudding. There was no concealing what had happened and in lachrymose mood nurse [sic] made her report to the Sister in charge of the floor.36